Sidelined By Runner’s Knee: Patellofemoral Pain


In my relatively short tenure as a runner, I’ve endured my share of aches and pains. I’ve fallen to the ground twice,  thanks to uneven sidewalks– chalk-up two wrist contusions. I’ve supinated my ankle after my first half marathon– peroneal tendinitis. Then there was the time that I was looking down at my shoelace while turning a corner– yah, that was dumb– I rammed my right shoulder into an anchored bus-stop sign. Why do they put those damn poles in the middle of a sidewalk, anyway? I’m not even counting the endless string of days when I first started running, where I was certain that everything beneath my skin was turning to mush. My muscles felt like hamburger meat and my body and bones rebelled. Like an annoying neighbor, pain and injury are beginning to feel very familiar and entirely unwelcome. Which brings me to today.

Runner’s Knee: patellofemoral pain. My right knee has been nagging me now for the past 50 miles of training. My sights were set on Lodi’s Avenue of the Vines half marathon in May. Today, I’ve pulled myself from the race– kicking and screaming. Sidelined. Ugh!

I’ve been wrestling with this for a few weeks now and finally pulled the trigger. The string of consolations by those who know me are nice, but fall short. “There will be other races,” and “you’re doing the right thing by resting your knee.” I’ve heard, “It happens to every runner; it’s only a matter of time.” Yesterday, a non-runner snarked, “Now you have an excuse to sit on the couch– you know you want to.” Clueless. She doesn’t get it. My inner-ultra-athlete was shouting, “I don’t want an excuse! I don’t want to sit on the couch!”

I really wanted to run the Avenue of the Vines. I have an emotional connection to that particular race because it was “where it all began” for me. I’ve written before about the epiphany I had one year, on Mile 11 of the course, in a post titled, I Killed the Waterboy. It changed my life.

My doctor– an ultramarathon runner– holds out hope for me. He delivered a diagnosis with one-part scolding (totally fine, he knows what it takes to get my attention) and two-parts encouragement. We talked about causation: shoes, stretching, quad strength and overall conditioning, kneecap position and gait. And then he got to the good stuff– prevention. It’s what I wanted to hear. For me, preventing the injury in the first place is the most logical place to start. To that end, I thought I’d paraphrase some of what we discussed:

Prevention

“Chuck, get in shape.” Anyone who knows me, knows you better not get between me and my pizza. Same goes for ice cream. A Mountain Mike’s Pizza buffet is like crack cocaine for me. Doc said that good general conditioning is important to preventing knee pain. I could stand to lose a few.

“Let’s talk about your stretching.” Before he could finish his sentence, my inner-Gordon Gekko was shouting, “Stretching? Stretching is for wimps!” (“Lunch” reference from Wall Street, 1987). Then I tuned back in to the good doctor as he reminded me to stretch and warm up before any exercise.  Face-down stretches in the prone position will support structures around the front of the knee. For example, while prone grab the ankle of the affected leg with one hand, and gently stretch the front of the knee.

“Chuck, don’t be in such a hurry. Train gradually.” He knows me well. I’ve made the same mistake that scores of newbies before me, make. Over-training is hard on the body. We talked about a strategy to lessen the shock to my body, inflicted by intense exercise. Tortoise and the hare. I’m the tortoise.

“Show me your shoes.” I thought my shoes were pretty good… and Doc agreed. Whew! Well, almost. My shoes were built with good shock absorption and overall high quality construction, yet he thought they were nearing the end of their useful life and encouraged me to upgrade. They have a good 350-miles on them, so it’s probably time.

“Show me how you run. I want to see your form.”I thought that was an odd request. I mean, those patient rooms are tiny, with a capital T. “I’ll hardly break a sweat,” I joked to myself.  What he meant was, do I lean forward and keep my knees bent? Am I running straight down– or up– a hill, or zig-zagging? Do I change my gait when I’m on an incline, or getting tired? I agreed to pay attention to these things when I felt better.

I found this really good instructional on knee conditioning: http://orthoinfo.aaos.org/PDFs/Rehab_Knee_6.pdf

So, I’m sidelined by knee pain. It’s not the end of the world, I suppose. After all, there will be other races. I’m doing the right thing by resting my knee. Perhaps it was only a matter of time and I’m sure it happens to every runner at some point. At least now I can just sit on the couch and watch life pass me by! Uh… NO!

I’m very interested in hearing how you deal with staying sane while sidelined by injury. Please let me know in the comments, below. 

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6 thoughts on “Sidelined By Runner’s Knee: Patellofemoral Pain

  1. Excellent post! And, great graphic and description of the of your injury. I had two knee surgeries in 12 months in 2009, and when your an aging runner, face it, it just take longer to rehab. My surgeon told me I’d better start running shorter races and think about other forms of arobic exercise, which I did. I cycle more and cut way back on my miles. I also started with fish oil and glucosamine-chondriotin. I never stretched either, but not do a simple lung on each side a young runner taught me last summer, it’s a miracle. Now, as far as rest here’s what I’ve told other runners and it’s worked. You can’t run injured, so rest. Pretty simple. My daughter’s friend, Therese, injured herself one month before the Philly marathon last year. She was up to a 17-mile training run. I told her rest, and if she felt injury-free on race day, line up. She did and finished her first marathon. And, I ran my first marathon in four years in November. So my advice, rest.

    • Thanks Jim. I’ll rest my knee. This knee pain kind of took me by surprise… because, up until a few weeks ago, my knees – like my back- have been unremarkable and not even on the radar. Strong. My ankles have been my proverbial Achilles Heel. I guess I’ll need to face the age thing, head on! Ugh.

  2. Chuck, one of my chief goals while running is the simple goal of not getting injured. The prospect of knee pain scares me. A couple of months ago, I inexplicably woke up with hip pain — a full two days after my last track workout.. Anyway, I just rested and hoped that a short break would do the trick. I had to skip a Ten Mile Race that I had really enjoyed a year ago. But I wasn’t in shape and it wasn’t worth it. In general, I rarely run over four miles. And I run just three times a week, leaving plenty of time to recover. The downside is that my race times have stopped improving. But I can keep running!

    • John, you may remember some of my writing from a couple years ago when I started running. I said that the ONE thing I cannot accept is an injury, because at the time, that was all it would take to take me out. I KNEW then, that I would use an injury as an excuse to quit. Well now, thankfully, I KNOW that it won’t. I have never run for speed, or to compete. I’ve run for much more subtle, personal reasons. I too, run between 3-7 mile training runs. That’s the distance that is in my wheelhouse. I’ll heal, and I’ll get back to it. I’m just sort of bummed about sitting out this particular race. Thanks for your reply.

  3. Well Chuck, when I was injured in a car accident, I cried for the first two weeks – didn’t want to give up my legal career. But once I realized that I had to I decided to start writing, and so I did. I returned to college, earned a few diplomas in writing and then started to write my books. I think you’d do great at writing a book. You could call it, “My Achy Breaky Bod”, by Chuck Douros.

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